摘要
目的 探讨血清Vasohibin-1(VASH-1)蛋白、同源盒转录反义RNA(HOTAIR)表达与糖尿病视网膜病变(DR)的关系.方法 按照1:1:1比例选取2021年1月—2023年1月陕西省人民医院内分泌科收治的增殖性DR(PDR)患者60例(PDR亚组)、非PDR(NPDR)患者60例(NPDR亚组)、非DR(non-DR,NDR)糖尿病患者60例(NDR亚组)作为T2DM组,另选取健康体检者90例为健康对照组,采用酶联免疫吸附法与实时荧光定量PCR检测血清VASH-1蛋白、HOTAIR基因表达;Spearman法分析T2DM患者血清VASH-1、HOTAIR表达与血糖参数的相关性;多元无序Logistic回归分析T2DM患者DR发生发展的影响因素;绘制ROC曲线评价血清VASH-1、HOTAIR表达对DR和PDR的预测价值.结果 与健康对照组比较,T2DM组血清VASH-1、HOTAIR表达升高(t/P=14.646/＜0.001、14.203/＜0.001).NDR 亚组、NPDR 亚组、PDR 亚组血清 VASH-1、HOTAIR 表达依次升高(F/P=11.728/＜0.001、43.850/＜0.001).T2DM患者血清VASH-1、HOTAIR表达与空腹血糖、糖化血红蛋白(HbA1c)呈正相关(VASH-1:r/P=0.210/0.005、0.458/＜0.001;HOTAIR:r/P=0.220/0.003、0.482/＜0.001).T2DM 病程长、HbA1c 高、VASH-1高、HOTAIR 高为 T2DM 患者 DR 发生发展的独立危险因素[OR(95％CI)=3.108(2.110～4.579)、6.634(2.761～15.940)、1.996(1.427～2.792)、2.600(1.683～4.015)],其亦是 PDR 发生发展的危险因素[OR(95％CI)=2.011(1.487～2.719)、3.643(1.719～7.719)、1.587(1.196～2.104)、1.686(1.201～2.366)].二者联合预测 DR 与 PDR的 AUC 分别为0.869与 0.886,大于血清 VASH-1、HOTAIR 表达单独预测的 0.803、0.785 与 0.787、0.778(Z/P=2.986/0.003、3.230/0.001、3.581/＜0.001、3.837/＜0.001).结论 血清 VASH-1、HOTAIR 表达升高是 T2DM 患者DR发生发展的独立危险因素,血清VASH-1联合HOTAIR高表达预测DR与PDR的价值较高.
Abstract
Objective To investigate the relationship between serum Vasohibin-1(VASH-1)protein,homeobox transcript antisense RNA(HOTAIR)expression and diabetic retinopathy(DR).Methods According to the ratio of 1:1:1,60 patients with PDR(PDR subgroup),60 patients with non-PDR(NPDR subgroup)and 60 patients with non-DR(NDR sub-group)admitted to the Department of Endocrinology in Shaanxi Provincial People's Hospital from January 2021 to January 2023 were selected as the T2DM group,and 90 healthy subjects were selected as the healthy control group,the expression of serum VASH-1 and HOTAIR was detected by enzyme-linked immunosorbent assay and real-time fluorescence quantita-tive PCR;Spearman method was used to analyze the correlation between serum VASH-1,HOTAIR expression and blood glucose parameters in T2DM patients;Multivariate disordered Logistic regression was used to analyze the factors of DR in patients with T2DM;ROC curve was drawn to evaluate the predictive value of serum VASH-1 and HOTAIR expression for DR and PDR.Results Compared with the healthy control group,the expression of serum VASH-1 and HOTAIR in the T2DM group increased(t/P=14.646/＜0.001,14203/＜0.001).The expression of serum VASH-1 and HOTAIR in NDR sub-group,NPDR subgroup and PDR subgroup increased in turn(F/P=11.728/＜0.001,43.850/＜0.001).The expression of serum VASH-1 and HOTAIR in T2DM patients was positively correlated with fasting blood glucose and glycosylated hemoglobin(HbA1c)(r/P=0210/0.005,0.458/＜0.001,0220/0.003,0.482/＜0.001).The independent risk factors for the occurrence and devel-opment of DR in T2DM patients were long course of T2DM,high HbA1c,high VASH-1 and high HOTAIR[OR(95％CI)=3.108(2.110-4.579)/2.011(1.487-2.719),6.634(2.761-15.940)/3.643(1.719-7.719),1.996(1.427-2.792)/1.587(1.196-2.104),2.600(1.683-4.015)/1.686(1201-2 366)].The AUC of DR and PDR predicted by the combination of the two was 0.869 and 0.886,respectively,which were higher than the AUC predicted by serum VASH-1 and HOTAIR expression alone,which were 0.803,0.785,and 0.787,0.778,respectively(Z/P=2.986/0.003,3230/0.001,3.581/＜0.001,3.837/＜0.001).Conclusion Elevated serum VASH-1 and HOTAIR expression are independent risk factors for the occurrence and development of DR in T2DM patients.Serum VASH-1 combined with HOTAIR expression has a high value in predicting DR and PDR.
维普
万方数据